Gastroenterology Emergencies Flashcards
All of the following are considered part of the lower gastrointestinal tract EXCEPT the:
Question 1 options:
A)
ileum.
B)
duodenum.
C)
jejunum.
D)
large intestine.
duodenum
All of the following contribute to the pathogenesis of diverticulosis EXCEPT:
Question 2 options:
A)
increased colon pressure.
B)
herniation of mucosa and submucosa through the teniae coli.
C)
low-fiber diet.
D)
decreased colon motility.
decreased colon motility
Your patient, who has a history of cholecystitis, is experiencing pain in her right shoulder. She is most likely experiencing ________ pain.
Question 3 options:
A)
peritoneal
B)
somatic
C)
referred
D)
visceral
referred
Your patient is a 22-year-old female in mild distress that is complaining of left lower quadrant abdominal pain and nausea. Which of the following questions would be least helpful when determining the etiology of her abdominal pain?
Question 4 options:
A)
“Have you ever had a sexually transmitted disease?”
B)
“How would you describe the pain: dull, sharp, constant, intermittent?”
C)
“When did the pain start?”
D)
“Are you having any vomiting or diarrhea?”
have you ever had a sexually transmitted disease
Your patient is a 44-year-old female complaining of a three-day history of localized abdominal pain in her midepigastric region after eating. The pain tends to subside with antacids. Today she is experiencing nausea, and the pain did not subside with antacids. The patient gives a history of smoking and moderate alcohol consumption. The patient’s skin is warm and dry, and she has a blood pressure of 128/88, a heart rate of 84, and respirations of 20. Your course of treatment should consist of:
Question 5 options:
A)
sodium bicarbonate IV.
B)
high-concentration oxygen by nonrebreathing mask.
C)
transporting the patient in a position of comfort and giving reassurance.
D)
IV of NS with 250 cc fluid bolus.
transporting the patient in a position of comfort and giving reassurance
While palpating the lower abdomen of a 63-year-old male complaining of back pain, you note a pulsating mass. You should:
Question 6 options:
A)
ask your partner to confirm the finding.
B)
determine if the mass is fixed or freely mobile in the abdomen.
C)
ask the patient to take a deep breath, then palpate the mass while he exhales.
D)
stop palpating.
stop palpating
Your patient is a 42-year-old male with a history of alcohol abuse who is in severe distress with dysphagia and hematemesis. You note that he is becoming lethargic and is having trouble keeping his head up. His skin is cool and clammy. HR = 138, BP = 82/56, RR = 8, SaO2 = 90%. Proper treatment of this patient would include all of the following EXCEPT:
Question 7 options:
A)
dopamine infusion.
B)
IV of NS with fluid challenge.
C)
placing the patient in shock position.
D)
aggressive suctioning of the airway and intubation.
dopamine infusion
Your patient is a 46-year-old male truck driver who is sitting on a toilet complaining of bleeding with defecation. He states that he had to strain significantly to produce a bowel movement, then noted blood on his stool afterward. He claims no significant medical history, has had no recent illness, and takes no medications. You note the presence of bright red blood on the surface of his stool. Of the following, which is the most likely cause of his clinical condition?
Question 8 options:
A)
Colitis
B)
Crohn’s disease
C)
Upper GI bleed
D)
Hemorrhoids
hemorrhoids
Your patient is a 12-year-old male who is conscious and alert and complaining of diffuse abdominal pain. He states that the pain began about 3 hours after eating supper. He has had severe diarrhea and some vomiting. Any of the following could be therapeutic EXCEPT:
Question 9 options:
A)
Compazine.
B)
diazepam.
C)
IV of NaCl or lactated Ringer’s solution.
D)
Zofran.
diazepam
Which three mechanisms can produce visceral pain?
Question 10 options:
A)
Peritonitis, cholecystitis, and a ruptured abdominal aorta
B)
Somatic, referred, and peritonitis
C)
Blunt trauma, penetrating trauma, and medical illness
D)
Distension, ischemia, and inflammation
distension, ischemia, and inflammation
Your patient is a 68-year-old female who is being treated for colon cancer. She is conscious and alert, in mild distress, and complaining of progressive weakness over the past three days. Palpation of her abdomen reveals tenderness to the lower right quadrant. Her skin is pale, cool, and dry, and you note the smell and appearance of melena in her stool. HR = 108, BP = 100/60, RR = 12, SaO2 = 97%. Proper treatment of this patient might include:
Question 11 options:
A)
two large-bore IVs of lactated Ringer’s solution, wide open.
B)
IV of 5 percent dextrose solution at 30 mL per hour.
C)
two large-bore IVs of normal saline, 20 mL/kg fluid bolus.
D)
IV of normal saline with a 250 mL fluid challenge, repeated if necessary.
two large bore IVs of normal saline, 20 mL/kg fluid bolus
Your male patient complaining of abdominal pain describes his pain as a dull, crampy sensation that is making him nauseous. The patient is most likely describing ________ pain.
Question 12 options:
A)
parietal
B)
referred
C)
somatic
D)
visceral
visceral
Which of the following correctly lists the organs and regions of the gastrointestinal tract in sequence after the stomach?
Question 13 options:
A)
Duodenum, jejunum, ileum, ascending colon, transverse colon, descending colon, rectum, anus ( correct)
B)
Duodenum, ileum, jejunum, large intestine, anus, rectum
C)
Jejunum, duodenum, ileum, large intestine, anus, rectum
D)
Duodenum, jejunum, ileum, descending colon, transverse colon, ascending colon, rectum, anus (wrong)
duodenum, jejunum, ileum, ascending colon, transverse colon, descending colon, rectum, anus
Your patient is a 68-year-old female complaining of diffuse abdominal pain. She has a history of intestinal hernias and adhesions from previous abdominal surgery. Your suspicion should be highest for:
Question 14 options:
A)
bowel obstruction.
B)
diverticulitis.
C)
ulcerative colitis.
D)
appendicitis.
bowel obstruction
Your patient is a 38-year-old female with a history of Crohn’s disease. She is conscious and alert and complaining of abdominal pain. She describes a one-week history of increasingly diffuse, crampy abdominal pain. She also states that she has had nausea and vomiting, fever, and diarrhea the past two days. Physical examination reveals that her skin is warm and dry and that her abdomen is tender to palpation in all quadrants with no masses or distension noted. HR = 100, BP = 118/78, RR = 14, SaO2 = 99%. Which of the following treatments is appropriate in the prehospital management of this patient?
Question 15 options:
A)
Ketorolac (Toradol)
B)
Methylprednisolone
C)
Antiemetics
D)
Diphenydramine
antiemetics
Increased hepatic resistance to blood flow, as happens in cirrhosis, results in:
Question 16 options:
A)
portal artery hypertension and ascites.
B)
hepatic vein hypertension and hepatic vein aneurysm.
C)
portal vein hypertension and esophageal varices.
D)
hepatic arterial hypertension and obstruction of the common bile duct.
portal vein hypertension and esophageal varices
Bleeding in the gastrointestinal tract proximal to the ligament of Treitz is considered to be in the:
Question 17 options:
A)
colon.
B)
upper GI tract.
C)
lower GI tract.
D)
small intestine.
upper GI tract
Which of the following properly accounts for the differences between visceral and somatic pain?
Question 18 options:
A)
The nerves that carry visceral pain impulses enter the spinal column at various levels, while the nerves that carry somatic impulses enter the spinal column via specific nerve routes.
B)
The nerves that carry somatic pain impulses enter the spinal column at various levels, while the nerves that carry visceral impulses enter the spinal column via specific nerve routes.
C)
Spilled organ contents and bacteria can result in visceral pain, while somatic pain is caused by organ distension.
D)
Visceral pain originates in the walls of hollow organs, while somatic pain originates in skeletal muscle.
the nerves that carry visceral pain impulses enter the spinal column at various levels, while the nerves that carry somatic impulses enter the spinal column via specific nerve routes
Pain that is well localized, allowing an examiner to pinpoint the area of irritation is ________ pain.
Question 19 options:
A)
visceral
B)
parietal
C)
referred
D)
somatic
somatic
Your patient is a 66-year-old female who is conscious and alert, complaining of a one-week history of progressive “lightheadedness” with exertion. She also complains of mild nausea; dark, sticky stools; and pain in her lower abdomen. Which of the following is the most likely cause of this patient’s condition?
Question 20 options:
A)
Acute cholecystitis
B)
Ingestion of an iron or a bismuth-containing medication
C)
Diverticulosis
D)
Gastrointestinal bleeding
GI bleeding
Your patient is a 19-year-old male complaining of a two-day history of abdominal pain described as diffuse and colicky, located around his umbilical area. He also states a loss of appetite and a low-grade fever over the same period. Palpation of his abdomen reveals tenderness and guarding to the periumbilical area. Of the following, which is the most likely cause of his clinical condition?
Question 21 options:
A)
Appendicitis
B)
Bowel obstruction
C)
Cholecystitis
D)
Peptic ulcer disease
appendicitis
Murphy’s sign is:
Question 22 options:
A)
bruising around the umbilicus.
B)
pain produced by pressing under the right costal margin in the presence of an inflamed gallbladder.
C)
petechial hemorrhage of the abdominal wall.
D)
pain produced by pushing 1 to 2 inches above the iliac crest on a line to the umbilicus.
pain produced by pressing under the right costal margin in the presence of an inflamed gallbladder
